Fasting and post-prandial plasma glucose screening for gestational diabetes mellitus.

BACKGROUND: Gestational diabetes mellitus (GDM) is defined as impaired glucose tolerance with onset during the second or third trimester of pregnancy. AIMS: The purpose of this study was to investigate the prevalence of pregnant women who were not screened for gestational diabetes mellitus and compare the maternal and fetal outcomes of women who had undergone GDM screening. METHODS: Women who refused to attend the gestational diabetes screening test (n = 162) at a maternity hospital in Ankara, Turkey, between October 2014 and January 2015 were included in this prospective cohort study. The control group (matched for age and body mass index) was recruited from women who agreed to have the gestational diabetes screening test (n = 194). RESULTS: Just 12% of pregnant women did not attend gestational diabetes screening test; these women were at higher risk for idiopathic polyhydramnios (P = 0.026). Prevalence of GDM was 8.8% (n = 17) in the control group and 30.9% (n = 50) in those who refused GDM screening. The maternal and fetal outcomes of GDM patients were similar in both groups. Women who did not attend GDM screening test had increased risk for mild idiopathic polyhydramnios in late gestation. CONCLUSIONS: Fasting and postprandial plasma glucose screening can replace gestational diabetes mellitus screening in women who refuse to have the glucose load test.

Second-trimester urinary neutrophil gelatinase-associated lipocalin levels in gestational diabetes: preliminary results.

OBJECTIVE: The objective of this study is to investigate the urinary neutrophil gelatinase-associated lipocalin (uNGAL) levels in the second trimester of pregnant patients at the time of gestational diabetes mellitus (GDM) screening. MATERIALS AND METHODS: Urinary samples from 88 pregnant women who underwent gestational diabetes screening test were collected in late second trimester (24-28 weeks) prospectively. After an overnight fasting, 75 g GTT was performed. The blood samples were drawn for measurement of glucose, insulin, and HbA1c. The urinary and blood parameters were compared for pregnant women with or without gestational diabetes. RESULTS: uNGAL levels were significantly elevated in pregnant women with gesting compared with the control groups (p < .014). There was a positive correlation between uNGAL and HbA1c levels (p = .001). CONCLUSIONS: In the second trimester, at the time of GDM screening, high levels of uNGAL indicate tubular injury in GDM cases which seems to be a result of hyperglycemia. uNGAL may correlate with an inflammatory renal involvement in GDM.

To evaluate the effect of pre-pregnancy body mass index on maternal and perinatal outcomes among adolescent pregnant women.

OBJECTIVE: To evaluate the effect of pre-pregnancy body mass index on maternal and perinatal outcomes among adolescent pregnant women. METHODS: We conducted this prospective cross-sectional study on 365 singleton adolescent pregnancies (aged between 16 and 20 years) at a Maternity Hospital, between December 2014 and March 2015. We divided participants into two groups based on pre-pregnancy body mass index (BMI): overweight and obese adolescent (BMI at or above 25.0 kg/m) and normal weight (BMI between 18.5 and 24.99 kg/m) adolescent. We used multivariate analysis to evaluate the association of the risk of adverse pregnancy outcomes and pre-pregnancy BMI. RESULTS: The prevalence of maternal overweight/obesity and normal weight was 34.6% (n = 80) and 65.4% (n = 261) in the study population, respectively. Compared with normal-weight teens (n = 234), overweight/obese teens (n = 71) were at higher risk for cesarean delivery (odds ratio [OR] 0.7, 95% confidence interval [CI] 0.4-1.4), preeclampsia (adjusted odds ratio [OR] 0.1, 95% confidence interval [CI] 0.02-0.9) and small of gestational age (odds ratio [OR] 0.2, 95% confidence interval [CI] 0.1-0.9). CONCLUSION: BMI increased during pre-pregnancy could be an important preventable risk factor for poor obstetric complications in adolescent pregnancies, and for these patients prevention strategies (e.g., nutritional counseling, weight-loss, regular physical activity) for obesity are recommended before getting pregnant.